ABSTRACT

Background: Known by some as the “invisible” people because of their precarious work and low social status, migratory and seasonal farmworkers (MSFW) are a critical and underappreciated component to the agriculture industry in the United States. Despite advances in knowledge about the health needs of this population, identifying geographies of high-risk remains a challenging task for community health workers and farmworker advocacy organizations.

Methods: Using patient encounter data (2011–2015) from regional Community and Migrant Health Centers (C/MHC), this study investigates the geography of farmworker chronic disease (diabetes, obesity, hypertension) and associated risk factors (anxiety, stress, depression, tobacco use) in Northeastern Colorado through the lens of Geographic Information Science (GIS).

Results: Spatial scan statistics (SaTScan) identified disease cluster hot spots in 151 zip codes and chronic disease risk factor clusters in 44 zip codes. Additionally, 13487 farmworkers or 82% of the total population is found in zip codes designated as chronic disease hot spots, while 10,115 or 62% of the population reside in zip codes identified as risk factor hot spots. GIS-based Network Analysis determined that 1,269 farmworkers lived greater than 30 minutes from a C/MHC, or 7.7% of the total population in the study area (n = 16,419).

Conclusions: The findings of this study confirm the need for geospatial analytics in farmworker population healthcare management. These methods, combined with multiple contextual and methodological perspectives, will inform appropriate outreach, research, and policy strategies, and further, serve to address the unique geographic challenges facing MSFW’s in Northeastern Colorado.

摘要

背景：由于工作不稳定和社会地位低下，移民和季节性农场工人 (MSFW) 被一些人称为“隐形”人，是美国农业的重要组成部分，但未被充分重视。尽管对该人群健康需求的了解有所进步，但确定高风险地区对于社区卫生工作者和农场工人倡导组织来说仍然是一项具有挑战性的任务。

方法：使用区域社区和移民健康中心 (C/MHC) 的患者遭遇数据（2011-2015 年），本研究调查了农场工人慢性病（糖尿病、肥胖症、高血压）和相关风险因素（焦虑、压力、抑郁）的地理分布, 烟草使用) 在科罗拉多州东北部通过地理信息科学 (GIS) 的镜头。

结果：空间扫描统计 (SaTScan) 确定了 151 个邮政编码中的疾病集群热点和 44 个邮政编码中的慢性病风险因素集群。此外，13487 名农场工人或总人口的 82% 位于被指定为慢性病热点的邮政编码，而 10,115 或 62% 的人口居住在被确定为危险因素热点的邮政编码。基于 GIS 的网络分析确定 1,269 名农场工人距离 C/MHC 的居住时间超过 30 分钟，占研究区域总人口的 7.7%（n = 16,419）。

结论：这项研究的结果证实了在农场工人人口医疗保健管理中进行地理空间分析的必要性。这些方法与多种背景和方法论观点相结合，将为适当的外展、研究和政策战略提供信息，并进一步解决 MSFW 在科罗拉多州东北部面临的独特地理挑战。